Live Birth Rate following Intrauterine Insemination in Women with Low or Very Low Level of Serum Anti-müllerian Hormone

Background: While anti-Müllerian hormone (AMH) level allows quantitative evaluation of ovarian reserve, its predictive value for live births following assisted reproductive technology cycles has remained controversial. The aim of the present study was to assess the importance of AMH in predicting live birth following intrauterine insemination (IUI) in the case of low or very low ovarian reserve. Methods: In this retrospective cohort study, 123 patients with AMH≤1 ng/ml, who underwent a total of 137 IUI cycles were enrolled and evaluated for live birth rate. Patients were divided into two groups based on serum AMH levels: group 1 with low level of AMH (0.4-1 ng/ml, n=83, cycles: 95) and group 2 with very low level of AMH (≤0.4 ng/ml, n=40, cycles: 42). The results were compared between the two groups. Main outcome was the pregnancy rate. Results: The rates of biochemical pregnancy, clinical pregnancy and live birth in all patients were 11%, 8% and 7.3%, respectively. The two groups showed no significant difference in the rates of biochemical pregnancy (10.4% vs. 14.3%, p=0.3), clinical pregnancy (6.3% vs. 11.9%, p=0.2) and live birth (6.3% vs. 9.8%, p=0.5). In univariate regression analysis, baseline characteristics and ovarian stimulation parameters showed no significant relationship with the rates of pregnancy and live birth. Conclusion: In women with AMH≤1 ng/ml, serum levels of AMH did not appear to reflect pregnancy outcomes and live births following IUI. It can be concluded that in women with low or very low levels of AMH, there is chance of pregnancy, and live birth following IUI.